Provider Demographics
NPI:1902459829
Name:ENLOE MEDICAL CENTER
Entity Type:Organization
Organization Name:ENLOE MEDICAL CENTER
Other - Org Name:ENLOE TRANSITIONAL SKILLED UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CFP
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-332-6733
Mailing Address - Street 1:1531 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3310
Mailing Address - Country:US
Mailing Address - Phone:530-332-6331
Mailing Address - Fax:530-893-6849
Practice Address - Street 1:340 W EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7238
Practice Address - Country:US
Practice Address - Phone:530-332-6138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility